The Tavistock: A huge Life and a rather quiet ending
My first job there was as part of the innovative Monroe Young Family Centre in 1991 set up by Dr Judith Trowell, psychiatrist and psychoanalyst, to work with young families where there was serious abuse. It was an extraordinary project. Parents with very young children at risk of being taken into care were offered a weekly assessment program and then a 3 day a week treatment program which included psychotherapy, family therapy, play therapy, psychiatric input and psychology, with psychoanalytic and observational approaches central.
The work at the Monroe was painful but eye opening, both brave and innovative. A partnership was set up with National Children’s Home. That was the kind of thing you could do in those days, have a big idea, think deeply about it and put it in to practice. That for me was a large part of what made the Tavistock amazing then, and in large part that is what it lost in its later years.
Founded by Hugh Crichton Miller over 100 years ago, the Tavistock was from the start a beacon of exciting new thought and practice. It was one of the first places to treat what was then called shellshock (now called PTSD). People came to work there because of deep interest in new ideas and treatment possibilities, often working unpaid.
Miller’s aim was to be independent of orthodoxies, including strict Freudian ones, being open to Jungian, Adlerian and French schools and aiming for a genuinely bio-psycho-social approach. Going back to the history, it was the place where Bion took forward so many new ways of thinking and literally changed worlds, even inviting CJ Jung to lecture.
Of the works of the early decades, the one that most influenced me was The Origins of Love and Hate by the unfortunately still too unknown Ian Suttie. Suttie died in 1935 at just 46, sadly just as the book came out, but his book presaged Bowlby and Winnicott and much contemporary developmental and trauma thinking in arguing for the role of ‘tenderness’ ‘ and seeing the primary drive of the infant as the urge for loving attachments. Here is a brief 1 minute video review I did a few years back when I did such things.
I of course immersed myself in the likes of Balint’s Basic Fault, , Bowlby on Attachment and Neville Symington’s inspiring take on psychoanalytic thinking well before I arrived there, although I did not know then that such thinkers were a bit different to the Tavistock staple of post-Kleinian theory. Arriving there felt like I was at the place where the gods lived and I wondered if dare even walk those corridors!
Later I undertook the child psychotherapy training there and I could not believe how lucky I was to be taught by true titans of the field. Margot Waddell made Elliot’s Middlemarch her set reading, arriving with random piles of spilling papers to evoke the most life-enhancing and deep talks imaginable on personality development, talks which eventually became Inside Lives. Anne Alvarez and Sue Reid led an autism workshop which was mind-blowingly innovative, again publishing their findings in a book. The infant mental health workshop was led by the likes of Dilys Daws (now over 90 and still my tutor!), the inimitable Juliet Hopkins, self-effacing but sharp as a razor, Lisa Miller and others. The same with a workshop on the emerging field of fostering and adoption and trauma, led by Jenny Kenrick, Lorraine Tollemarche and others.
There were so many others. Gianna Williams on eating disorders, Robin Anderson and Margot on adolescence, the lists could go on and on. But what was important was that each workshop was led by people who set them up because they had a passion for the subject and wanted to develop their understanding, and most importantly, they had the freedom to do so.
Such freedom to innovate was facilitated by Margaret Rustin, who for decades led pretty much everything about child psychotherapy in the UK and who always deeply believed in maintaining an intellectual life alongside clinical work and teaching. Scientific meetings were etched into my diary monthly on Mondays at 11.30 as unmissable and the best minds in the Trust were always there, and nearly always the ideas were revelatory. I remember hearing so many of the greats such as Ron Britton, Isca Witenberg, Caroline Garland, Harold Stewart, Phil Richardson, Andrew Cooper, Anton Obholzer, John Byng-Hall, Anne Alvarez, David Campbell, Charlotte Burck, so many .. and then there were the policy seminars led by Andrew Cooper and Sebastian Kraemer, where serious thinking about public policy was done, and also Frank Lowe’s Thinking Space which focused on what we would now call intersectionality. There was so much innovation and important thinking.
When I eventually returned to work there having been learning my trade as a child psychotherapist and also developing community work for some years, I was struck by what was possible. I could set up a service for working in schools, come up with an idea and put it into practice without umpteen committees. Managers such as Hamish Canham and Lisa Miller in those days just supported innovation. That is how new services, workshops, books and courses began, from passion, belief and deep thinking. We set up new courses, I even developed my own workshop on trauma and the body and a whole new briefer psychotherapy training. Let’s not idealize. There was rivalry, vying for status and I know I for one did not really fit in with my strange new thinking about neuroscience and attachment and different forms of therapeutic work.
We worked hard, and if unlike the early pioneers who gave of their time freely, we were paid , but not for the hours we worked, and we often were there late in the evenings and weekends, putting our hearts and souls into what we were passionate about. It was a kind of family, with its struggles, arguments, envies but a place where you could pull together. Literally many hundreds of books have been published by Tavistock Clinicians, and many thousands of papers, and many many thousands of keynotes and public talks. That is without the thousands of students who have trained there, who have attended short courses and conferences and most of all, the patients/clients who were so often, if not always, helped by their therapy. We know so little of the ripple effects, I heard just last week that someone was told by an adoptive parent how profoundly their parenting changed after input from us 20+ years ago.
So some of what we did will live on, perhaps over generations, even though the Tavistock is no more. It will always be in our minds, as a kind of ego ideal, perhaps an ancestral beacon lighting our way. I suspect it had not been what it once was for a fair amount of time. In the last decade or so there was so much less intellectual life, less innovation, less publications.
There were exceptions, such as Jo Stubley’s amazing work in the trauma clinic is the prime example, but perhaps increased management, bureaucracy and financial constraints knocked the stuffing out of that once amazing place. By the end its clinical thinking had less influence, and of course the controversy around the Gender Clinic was a kind of final nail in a coffin we should have seen coming. Below are a few articles about the Tavistock’s end, by Margaret Rustin and also John Launer.
So thank you Tavistock Clinic. It was a complicated but amazing place. I know I often did not fit in and at times it was painful to be there, but it was always a place of growth, excitement and it was where I, like many, was given my wings. My happiest times were probably in the Fostering and Adoption and Kinship care team, a team that grew out of people insisting this was an important area of work and just doing it, one where family therapists and child psychotherapists and psychiatrists and social workers worked genuinely together in a respectful way and learnt from each other. I am so grateful too for the teams we set up to work in schools. Amazing to think I could set up a service with 2 days a week of therapy in every secondary school and special unit, and with amazing therapists who also worked in the clinic. I set up services in primary schools, got funded for a huge project working with what were then called minority groups and refugee communities, there was so much innovation and so much deep-thinking careful good work. I, like so many, have so much to be grateful for, for the learning, the opportunities, for piggy-backing on its history and reputation; I felt and still feel proud to have worked there.
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